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Effect of amphetamine on corrected-QT interval change during methadone maintenance treatment in Taiwan: a prospective

Ni-Chi Lin1, Chieh-Liang Huang, Chung-Ying Chen

  • 1Tsaotun Psychiatric Centre, Ministry of Health and Welfare, Nan-Tou, Taiwan.

Drug and Alcohol Review
|December 11, 2013
PubMed
Abstract

Insights

Methadone maintenance treatment can prolong the corrected-QT (QTc) interval in patients. Frequent amphetamine use is associated with QTc interval changes, highlighting the need for cardiac monitoring in at-risk individuals.

Area of Science:

  • Cardiology
  • Pharmacology
  • Addiction Medicine

Background:

  • Methadone is a common treatment for opioid use disorder.
  • Previous studies suggest methadone may prolong the corrected-QT (QTc) interval.
  • Limited prospective research exists on methadone's cardiac effects and associated risk factors.

Purpose of the Study:

  • To investigate QTc interval changes in patients undergoing methadone maintenance treatment.
  • To identify risk factors associated with QTc interval changes.
  • To explore the specific effect of amphetamine use on QTc interval.

Main Methods:

  • Prospective cohort study with a six-month follow-up.
  • 170 heroin users in a methadone maintenance program in Taiwan were assessed.
  • Electrocardiograms (ECGs) were performed at enrollment and six months; demographic and substance use data were collected.

Main Results:

  • A mean increase in QTc interval of 17.1 ms was observed over six months (P < 0.001).
  • QTc interval prolongation increased from 2.9% at baseline to 12.4% at six months.
  • Higher frequency of amphetamine use correlated positively with QTc interval change; methadone dose did not.

Conclusions:

  • Methadone maintenance treatment is associated with a significant increase in mean QTc interval.
  • Electrocardiogram monitoring is recommended for patients at risk of frequent amphetamine use during methadone treatment.
  • Comorbid amphetamine use is a significant factor influencing QTc interval changes in this population.
Keywords:
amphetamineelectrocardiogrammethadone

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